The Functional-Organic Dichotomy: Postinfectious Irritable Bowel Syndrome and Inflammatory Bowel Disease-Irritable Bowel Syndrome

Madhusudan Grover, Hans Herfarth, Douglas A. Drossman

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

Gastroenterologists often encounter situations when the clinical and pathophysiological features that typically distinguish functional from organic disorders overlap. This "blurring of boundaries" can occur with post-infectious irritable bowel syndrome (PI-IBS), a subset of IBS and a newly described entity IBD-IBS. The key associating features include pain and usually diarrheal symptoms that are disproportionate to the observed pathology, microscopic inflammation, and often a co-association with psychological distress. A previous initiating gastrointestinal infection is required for PI-IBS and assumed for IBD-IBS. Using this perspective we discuss the clinical and pathophysiological features of PI-IBS and IBD-IBS and the growing evidence for the overlapping features of these two disorders in terms of alteration of gut flora, immune dysregulation, and role of stress. A unifying model of PI-IBS and IBD-IBS is proposed that may have important clinical and research implications. It obligates us to reframe our understanding of illness and disease from the dualistic biomedical model into a more integrated biopsychosocial (BPS) perspective.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2009

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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